PG
Preston G

1 reviews | Active since Sept 2010

07 Sept 2022, 11:51

Poor Service from Claims Department

Claim submitted in May 2022. To date (September 2022), no feedback. Hollard Claims Assessors and Claims Administrators do not seem to know what they are doing, as everytime I called through they were unable to provide any information.

There was no oustanding information, no request for documents and no decision made on the claim. How can it take 5 months to process 1 claim?

I even wrote to the Hollard Complaints department in August 2022, yet again I have not received any feedback.

0
Replies (14)
PG
Preston G's update07 Sept 2022, 14:41
Reviewer Update
Good day.

Thank you for your prompt feedback, Acknowledgement of the Delays and commitment that the matter will be resolved within 5 working days.

It must be noted that:

1. The communication between your Senior Claims Assessors and myself was NOT as a result of a response from Hollard Claims Department nor as a response from Hollard Complaints Department.
The conversation with Daryn Thompson only occurred because I had to follow up after not receiving feedback from the Claims and Complaints Department, and was lucky enough to get the contact information of a Claims Manager.

2. Whilst the PMA was requested on the 12 August 2022, the documents were only sent through correctl to the Doctor on the 30 August 2022.

3. Between 9th June and 12th August there seemed to be no activity on the claim.

Again, I thank you for your feedback and ask that the issues and shortcomings within your various departments be addressed so that your Customers do not have to endure difficulties.


Hollard Life
Hollard Life's reply13 Sept 2022, 16:22
Official
Hello Preston,

Will follow up with the claims department and get back to you with feedback tomorrow.

Kind Regards,

Escalated Complaints Team
Hollard Life
Hollard Life's reply14 Sept 2022, 10:20
Official
Hello Preston,

Please note that case is still being revived by our claims assessor it seems they requested for more information from Dr Bhagwan which was received yesterday.

Kind Regards,

Escalated Complaints Team
PG
Preston G's update15 Sept 2022, 11:32
Reviewer Update
Good day.
Thank you for the feedback as promised.

I may be wrong, but logically it doesn't make sense.

According to the information sent previously, by the claims department , the PMA was receipted from the Doctor on 07/09/2022.
As I'm informed, a PMA is quite comprehensive and there isn't much more information that could be provided, that isn't already included in the PMA.

I followed up with the Doctors Rooms, and was informed that they had only sent through the PMA on the 13/09/2022. I asked about any other documents that they had sent through, the Doctors Rooms confirmed that it was only the 1 document. There was no other information requested.

It seems that Staff at Hollard are taking liberties with the statements made.

Please note the following issues:
1. The PMA was requested on 12th August, after two months of no activity on the claim.
2. The PMA Documents was only sent through to the Doctor on the 30th August.
3. Claims confirmed in writing that they received the PMA on 7th September.
4. The Doctors Rooms states the PMA was only sent through on 13th September.
5. Previously, correspondence was being sent to email addresses to which I have no affiliation and which was not provided by me, which I'm informed is a breach of the POPI Act.

Please advise if this is how Hollard employs the notion of Treating Customers Fairly ?

Based on the above, it seems that I am getting no joy in dealing with Hollard, I believe I have no other choice but to refer the matter to the Ombudsman or FSCA.
Hollard Life
Hollard Life's reply15 Sept 2022, 12:15
Official
Hello Preston,

We acknowledge receipt of the above and assure you that our claims team is busy assessing your claim.

We have shared your frustration with our claims management team and we will be in contact with you once we receive feedback from management.

Kind Regards,

Escalated Complaints Team


PG
Preston G's update15 Sept 2022, 15:54
Reviewer Update
Noted with Thanks.

I will await a timeous response from you, befor I take the matter to the Ombud.
Hollard Life
Hollard Life's reply15 Sept 2022, 16:48
Official
Hello Preston,

Thank you.

Kind Regards,

Escalated Complaints Team
PG
Preston G's update16 Sept 2022, 13:22
Reviewer Update
Good day.

I received the below message from the claims department yesterday:

"15.9.2022: As this is a very early claim, we need to complete the verification of your medical history. Based on information on the medical aid records, we require a PMA from Dr AB Maharaj and will request this internally. Additional information will also be requested from the Occupational The****** seen. We will advise when this information is received."

While I can understand that Hollard needs to do Verification of Medical History, this is something that should have been done in the 1st Week of the Claim, a Customer should not wait for 5 months for Hollard to start / complete a Verification Process.

As the Hollard Claims Department has dropped the ball in so many instances, by not sending documents timeously, sending documents via incorrect channels, and by taking liberties with the statements made I am pleading with you to ensure that the processes are done correctly and speedily.

Please instruct your people to follow up on the PMA document and ensure they receive the required documents within the next week.

The manner in which this claim is being handled is just not right.
To think once upon a time Hollard was one of the better companies to deal with.
Hollard Life
Hollard Life's reply19 Sept 2022, 08:21
Official
Hello Preston,

I fully understand your frustration in this matter and i can assure you i am following up  on my side to make sure that this matter is resolved as soon as possible, as they have mentioned this  being an early claim and therefore all the necessary steps need to be followed i do acknowledge that this has caused a lot of frustration from your side and for that Mr Govender i apologies profusely.

Kind Regards,

Escalated Complaints Team
PG
Preston G's update28 Sept 2022, 10:44
Reviewer Update
Once again I am left truly shocked at the pathetic level of service from Hollard.

I received notification that the PMA from Dr AB Maharaj was still outstanding, and the sender of the email assured that they were following up regularly with the Doctor to ensure the documents were received as soon as possible.

As the PMA was requested on the 15th September, and today being 2 weeks later, surely the Doctor should not take this long.
I took it upon myself to follow up with The Doctors Rooms, only to find out that Fortune (Hollard), had only sent through the PMA forms on Monday 26th September. YET IT WAS REQUESTED ON 15TH SEPTEMBER.

What were you guys waiting for? Why was the documents sent through 11 days later?

This is beyond unacceptable.

I am informed that the Doctor has sent through the invoice and is awaiting payment. Kindly ensure that this is done.

It's really sad that this is the only platform where I get some assistance.
You apologize on behalf of other departments and yet they make no improvements and perform at a more pathetic level.

The level of service is something that your senior management needs to address.
Hollard Life
Hollard Life's reply28 Sept 2022, 17:51
Official
Hi Preston,

Please note that the invoice has been paid for, i will personally send it through to the doctors rooms tomorrow morning.

I did try to contact you on your cell phone to advise you of this.

Kind Regards,

Escalated Complaints Team
PG
Preston G's update04 Oct 2022, 08:20
Reviewer Update
Good day.

Thank you for providing me with feedback and your assistance in getting things done.

Please can you advise as to when I will receive the outcome of my claim.

Regards
Preston
Hollard Life
Hollard Life's reply04 Oct 2022, 10:57
Official
Hello Preston,

Kindly note we have received the PMA from Doctor Maharaj. I can confirm that the case is being reviewed by an assessor as we speak. Will provide feedback as soon as possible as they will have to inform me once all the assessments is done from their side.

Kind Regards,

Escalated Complaints Team 
PG
Preston G's update05 Oct 2022, 10:07
Reviewer Update
A special thank you to Thelma from the Escalated Complaint Department for going the extra mile. Seeing the shortcomings of the other Departments, and taking the time to follow up and ensure that Good Service is provided.

To Hollard Management, it's people like Thelma who will help you build a successful business, people who are able to fulfill their duties with diligence and courtesy.
I strongly suggest that Hollard review the processes and implement realistic turnaround times with checks and balances so that your customers are treated fairly.